Nervenarzt. 2000 Mar; 71(3): 173-80.

[The concept of "evidence-based medicine" in psychiatry. A path to a more rational psychiatry?]

Berner MM, Rüther A, Stieglitz RD, Berger M.

Abteilung Psychiatrie und Psychotherapie, Klinikum der Albert-Ludwigs-Universität, Freiburg. michael_berner@psyallg.ukl.uni-freiburg.de

Many of the diagnostic and therapeutic procedures in psychiatry and psychotherapy are based on opinion rather than evidence. The concept of evidence-based medicine aims to bridge the gap between clinical research and clinical decision-making by integrating the best available external evidence with personal expertise. In this article, we demonstrate several examples of the non-evidence-based medicine paradigm. Then we show the usefulness and practicability of the new evidence-based medicine paradigm by using a clinical example. Finally, we discuss the consequences, chances, and limitations of this new model. We also examine the role of the individual clinician's viewpoint as well as the need of institutional re-engineering and the possible restructuring of the entire health care system towards evidence-based methods.